# DR. DANY YOUSSEF JABBOUR

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1528073822
- **Gender:** Man
- **Credential:** DPM

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213E00000X | Podiatrist | 006140 | NY | — |
| 213EP1101X | Primary Podiatric Medicine Podiatrist | 006140 | NY | — |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | N006140-01 | NY | Yes |

## Other

- **Enumeration date:** 07/29/2006
- **Last updated:** 09/09/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000932161004 | BS NORTHEASTERN NY PIN/IDENTIFIER | — |
| 05 | — | 02911622 | — | NY |
| 01 | — | 30061 | TAX ID LAST 5 DIGITS | — |
| 01 | — | 93-2014012 | TAX ID | NY |
| 01 | — | CJ2100 | RAILROAD MEDICARE GROUP PIN/IDENTIFIER | — |
| 01 | — | GRP408871001 | BLUE SHIELD NORTHEASTERN NY GROUP PIN/IDENTIFIER | — |
| 01 | — | PM4111 | BLUE CROSS PRUE SHIELD PIN/IDENTIFIER | — |